Healthcare Provider Details

I. General information

NPI: 1982937470
Provider Name (Legal Business Name): UNIFIED SCHOOL DISTRICT 459
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2009
Last Update Date: 09/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 S MAIN ST
BUCKLIN KS
67834-3433
US

IV. Provider business mailing address

PO BOX 8
BUCKLIN KS
67834-0008
US

V. Phone/Fax

Practice location:
  • Phone: 620-826-3828
  • Fax: 620-826-3377
Mailing address:
  • Phone: 620-826-3828
  • Fax: 620-826-3377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: W. S. LANDIS
Title or Position: SUPERINTENDENT
Credential:
Phone: 620-826-3828